Physical activity and kinesiophobia: A systematic review and meta-analysis

OBJECTIVE. Physical activity contributes to the primary, secondary, and tertiary prevention of multiple diseases. However, in some patients, an excessive, irrational, and debilitating fear of movement (i.e., kinesiophobia) is thought to induce avoidance behaviors, contributing to decreased engagement in physical activity. The aim of this study was to examine whether kinesiophobia is negatively associated with physical activity in several health conditions and what factors may influence this relationship. METHODS. Five databases were searched for studies including both a measure of kinesiophobia and physical activity. Two reviewers screened articles for inclusion, assessed risk of bias, and extracted data from each study. Pearson product-moment correlations were pooled from eligible studies using the generic inverse pooling and random effects method to examine the relationship between kinesiophobia and physical activity. RESULTS. Seventy-four studies were included in the systematic review and 63 studies (83 estimates, 12,278 participants) in the main meta-analysis. Results showed a small-to-moderate negative correlation between kinesiophobia and physical activity (r = -0.19; 95% confidence interval: -0.26 to -0.13; I2 = 85.5%; p < 0.0001). Funnel plot analysis showed evidence of publication bias, but p-curve analysis suggested that our results could not be caused by selective reporting. A subgroup meta-analysis showed that the correlation was statistically significant in patients with cardiac, rheumatologic, neurologic, or pulmonary conditions, but not in patients with chronic or acute pain. CONCLUSION Our results suggest that higher levels of kinesiophobia are associated with lower levels of physical activity in several health conditions that are not necessarily painful. IMPACT. Kinesiophobia should be dissociated from pain and considered in relation to specific health conditions when implementing interventions to promote physical activity. Kinesiophobia may have prognostic implications in patients for whom physical activity contributes to prevent recurrence or worsening of their condition. ### Competing Interest Statement The authors have declared no competing interest. ### Clinical Protocols <https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022364063> ### Funding Statement Matthieu P. Boisgontier is supported by Natural Sciences and Engineering Research Council of Canada (NSERC; RGPIN-2021-03153), the Canada Foundation for Innovation (CFI), Mitacs, and the Banting Research Foundation. Ata Farajzadeh is supported by an Admission Scholarship, a Doctoral International Scholarship, and a Special Merit Scholarship from the University of Ottawa. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All data, scripts, and materials used in the present study are available online at https://doi.org/10.5281/zenodo.11638244 (version 1.2). The study was pre-registered in PROSPERO: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022364063 <https://doi.org/10.5281/zenodo.11638244>

Bringing Open Science to formal education 🏫

Open Science is just good science in a digital age. And if we want students and early career researchers to become good scientist, we need to start implementing Open Science in formal education: In Bachelors and/or Masters degrees, in PhD programmes, and beyond. At the Open Science Retreat (see...

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